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General NPI Number Information
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NPI Number | 1053096446
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Entity Type | Individual
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Provider Name | RICHARD A PRECKEL
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Gender | Male
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 9401 N OAK TRFY STE 200
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City | KANSAS CITY
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State | MO
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Zip | 64155-3393
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Country | US
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Telephone | 816-720-5261
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Fax |
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Provider Business Mailing Address
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Address Line | 833 TARA ESTATES CT
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City | CHESTERFIELD
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State | MO
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Zip | 63005-3668
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Country | US
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Telephone | 314-640-4010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2024021875
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License Number State | MO
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